Provider Demographics
NPI:1821683517
Name:ELITE PHYSICAL THERAPY & SPORTS PERFORMANCE BLUFFTON
Entity Type:Organization
Organization Name:ELITE PHYSICAL THERAPY & SPORTS PERFORMANCE BLUFFTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:CRAPPS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:843-705-9480
Mailing Address - Street 1:4 OKATIE CENTER BLVD S STE 101
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7530
Mailing Address - Country:US
Mailing Address - Phone:843-705-9480
Mailing Address - Fax:843-705-9481
Practice Address - Street 1:38 SHERIDAN PARK CIR STE E
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-7023
Practice Address - Country:US
Practice Address - Phone:843-705-9480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty